My doctor put temporary plugs in my lower ducts last June when I was having major dry eye problems due to blepharitis. It kind of hurt when he first put them in and that night my eyes/eyelids were pretty sore and swollen. The pain wasn't as bad the next day, but I don't know if the plugs really helped my dry eyes all that much. I was still having to use a lot of artificial tears - almost every hour. My eyes were REALLY bad back then, though. The plugs dissolved after four or five days and my doctor gave me the option of inserting the permanent ones. I did seriously consider it because my dry eyes were causing me a lot of pain at that point. But in the end I opted not to have the plugs because I thought that I wouldn't be able to tell whether or not my eyes were healing on their own. So from that point on I was just very diligent about doing the warm compresses and lid massages, and I got the dry eye problem under control by August. My eyes have been fine ever since so I guess in the end I'm glad I didn't have the permanent plugs inserted. But that is just my experience. I'm sure there are other people out there who are very happy with the plugs. Hopefully they'll share their experiences with you so you can make a better decision for yourself. Good luck!

I've had plugs and they did help me, but not enough to make a difference. My dry eyes were (are) so severe that I had to get all 4 tear ducts permanently closed by cauterization, and I STILL don't have enough tears to keep my eyes comfortable.

Most people don't have a problem with plugs. It takes about 5 minutes to insert them, and they are 100% removable if you are irritated by them or if you just don't like them. But that's why most doctors recommend trying the dissolvable ones first. I started out with getting both lower ducts plugged. That helped a tiny bit (but in your case it would probably help a lot more. I have a very severe case.) So my doctor and I decided to try plugging the top two also. We did that and it helped a little bit more, but then the plugs started to irritate me. One moved and we think it was the cause of a corneal abrasion. Once that happened, my doctor immediately removed all 4 plugs. But he said that's very rare, and my eyes are the most sensitive he's ever seen. Then we did the cauterization, and that worked much better. I have a somewhat decent amount of tears now. All 4 ducts are cauterized. But 99% of people with dry eyes are probably better off with plugs. I just could not tolerate them.

Another problem with plugs, for me at least, is that after a while of having them in your tear ducts start to stretch and eventually you need a larger size plug. My plugs fell out repeatedly. Again, that probably doesn't happen with everyone.
My doctor also told me that the reason that cauterization worked better for me is because even with plugs, you cannot seal off the entire duct. There is still a teeny tiny space in between the plug and the skin where a miniscule amount of tears can escape from. For most dry eye sufferers that is fine, because once they have the plugs the dryness goes away regardless, even if a little bit of tears seeps out. Not me. I need every last bit that I can get.

The other thing that a lot of people notice is that right after they get any sort of punctal occlusion (closing of the tear ducts), they have an overflow of tears. It usually lasts for a few days until the eye can regulate the tear production accordingly.

In general, plugs are a very good choice for people with dry eyes. There are a few different kinds of plugs. The kinds that I can think of are just plain silicone plugs that stay in until the doctor removes them or they fall out, the dissolvable ones that are meant just for trying them out, and stay in for a few days, the kind that come as a sort of gel, and then mold to the inside of the tear duct and harden once they are inside (those are completely invisible and more difficult to remove because they are fully inside of the canal. They dissolve on their own in 3-4 months), and flow-through plugs which block enough tears from draining so that your eyes are not dry, but have a small canal in them so that you get a little drainage and you don't have as much overflow. You'd have to ask your doctor what kind he thinks is best for you. I had the solid silicone plugs because none of the others were out yet. Now my doctor said that he likes the dissolvable ones that stay in for 3-4 months because since they sit all the way inside the canal, they don't stick out and there is no chance of them scratching the eye. But he also warned me that he would never use those on me, because with my luck I'd have an allergic reaction to the material and he'd have a difficult time getting them out.

Some people also say that with punctal occlusion, bad bacteria and inflammatory cells can't leave the eyes, but I don't really believe that. If it weren't for punctail occlusion I'd have no corneas left.

I hope I gave you enough information to make an informed decision. You might also try going to [url]www.oculartimes.org[/url] and looking it up there. If the website is still in existence, there were some pretty nice pictures and a good explanation of how the doctor inserts them. I hope I haven't discouraged you from getting plugs! They really do help most people. Just not me!

Good luck, and I'd be happy to try and answer any more questions about this.

I had the tear duct plugs put in March 2003. I first went to my eye dr about vision problems, and she said that my eyes were really dry and did a schrimer test and found that I produced very little tears. I actually really never noticed that my eyes were excessively dry, but she said that since I had worn contacts for so long...my corneas were very desensitized.

She suggested I try the dissovable plugs, which I did. I didn't notice much difference with them, but my dr. suggested going for the permanent ones, since I could always end up removing them.

I agreed and got the permanent ones placed in on a Friday. The plugs pinch a little going in but she numbed the area first. After having them in, they felt a little uncomfortable and akward for a day or so. The left one felt fine after a little bit, but the right one continued to irritate my eye. It felt like it was rubbing up against my eye. The weekend was miserable and my right eye was really red. Monday morning I went to my dr.'s office for an emergency appt. She had to remove the right one because it just didnt sit down properly and was rubbing my eye. Luckily it didnt cause any permanent damage. And removing it was pretty easy.

My dr was ordering me a different style plug that should work for my eye, but I never got it put in. I have noticed no difference with the left one so figured it wasnt worth it. My dr. was a little surprised that I notice no difference since most people with them do. And even doing the schrimer test again, my left eye has not improved much.

Overall it really didn't do much for me, but it is something worth trying.

I had Lasik surgery and the laser must have burned the tear producing glands. I had plugs put in both my eyes. The left one irritated my eye and then fell out by itself. The right one is still in there and I notice absolutely no difference or improvement.

I read on a web site that people with severe dry eye should take Omega 3 and 6 capsules and women should add Evening Primrose oil. I've just started this because I'm getting desperate - I'm supposed to have 20/20, but I can barely see 20/60 because of blurriness due to severe dry eye. I drink about 4 liters of water a day, avoid caffeine, avoid chocolate, avoid salt, have a whole regimen of about 6 different drops and gels that I put in my eyes and constantly have water boiling on the stove to keep the environment moist. Good thing I work at home.... I would have been fired from a job site because I would not be able to stand working. I still have severe dry eyes and get severe eye strain and headaches now because my eyes are working far too hard just to be able to see. Once my eyes are hydrated properly, I do actually see 20/20 quite easily...but the bleeriness is just overwhelming. At this point, I would say I was better off wearing my glasses than getting Lasik eye surgery.

Has anyone gotten tear duct plugs? Did they work even marginally? Did they irritate your eye? Get an infection from it? Were they uncomfortable?...

Yep, upper & lower and they are working out well for me. The following day (after the uppers were inserted) the puncti was inflamed and the conjunctiva of same eye was red and glossy. I used toberdex for a couple of days and it went away. I have had persistent recurrent lower eyelid gland infections (2) that have yet to resolve. The eye doctor thinks it is related to my hormones (thyroid specifically, I have to go to an endocrinologist) I have been *flushing* my eyes with preservative free tears to in effect *wash* my eyeballs. I weighed the risks & read about a risk of higher counts of bacteria in the tears kept in the eyes for a prolonged period (by the plugs) that can cause infection etc but still opted for the plugs. All in all, it was well worth it and I'm glad I did. At times they can feel itchy otherwise I don't notice them.

Gemi,
Just curious...do you know you have a thyroid problem and your dr thinks eye problem might be related, or are you going to endo to see if you have a thyroid prob? Is yours over or under active?
I have an underactive thyroid. I actually have thought that some of my eye problems are related to it, have heard that autoimmune thyroid prob, Hashimoto's disease, can cause some problems. My eye dr never said anything about it, but usually eye problems go along with Grave's disease.

I had Lasik surgery and the laser must have burned the tear producing glands.

When you have lasik surgery, in order to make the flap they have to cut some of the nerves that supply tears to the cornea. Most people don't have a problem with this, but others don't produce enough tears after the surgery and they develop severely dry eyes. Did your doctor measure your tearflow and tear breakup time prior to surgery?

I have them, all four, permanent, and they were a godsend. Didn't hurt one bit to have them put in and it made a huge difference. My eyes were so dry even without contacts, that I had to wedge them open in the morning to put drops in even before I could open them. After the plugs they were watery for a month, one eye for three months, but felt so good and I could wear my contacts. After that, they adjusted and were normal. Definately do it if you need it.

Gemi,
Just curious...do you know you have a thyroid problem and your dr thinks eye problem might be related, or are you going to endo to see if you have a thyroid prob? Is yours over or under active?
I have an underactive thyroid. I actually have thought that some of my eye problems are related to it, have heard that autoimmune thyroid prob, Hashimoto's disease, can cause some problems. My eye dr never said anything about it, but usually eye problems go along with Grave's disease.

I'm sorry. I don't know how I missed your post.
The endo I saw (after tests and time, labs back and forth) am hyperthyroid , intermittant graves (because the labs are abnormal, then normal and around and around I go). At first, the tsh was suppressed (nervous, lost wt, temp fluctuations, palps etc) took tapazole first for 6 months then another 6 months (1yr total). Some time passed after I was off that until last year. I started having symptoms, was confused about them because they seemed to be combination hyper & hypo. The lab work showed consistent elevated lab values once with the t4 and the rest the t3 was higher. The last lab that I've seen the tsh was 2.5 which for me when that is normal is 1.5 and the t3 was higher. At the same time had ovarian cysts that lurked and a laporoscopy showing endometriosis (laser, lupron shots). It seems when the thyroid hormones are acting up, so does my palpabral lid along with the estrogen. When it rains, it pours...

My palpabral on the left upper lid gets injected (swollen). Capillarys are red, pain behind the eyes. Last IOP was 16left/17 right. Took restasis then the IOP was 15/16. I'm due to go to the eye doctor again, just rec'd the card in the mail. Another appointment, another doctor...

I tried the temporary plus (they dissolve in like 3-4 days) and besides my eyes (especially my left) being really watery, I didn't notice a tremendous difference. But I'm wondering if it takes longer to see an effect?
I'm having a lot of light sensitivity with my dry eye, and am wondering if I should try plugs again because I was too quick to write them off and didn't have enough time to truly notice a difference.
I used to wear contacts and would love to be able to get back into them again

The way I knew they were helping (which was immediate) was before I had them, the tears fell away and leaked from the outer corners (especially during allergy season). After the procedure, those tears lost, were now being kept inside the eye. That along with drops helps. During allergy season, the eyes were watery and leaking had to keep wiping the allergy tears away from the outer corners so often, it would become bright red. I did not have to do that anymore after the procedure but do have to keep using the drops....

I have severe dry eye and tried the permanent silicon plugs. I had my eye dr take them out after 5 days because I could feel them touching my eyeballs when I moved my eyes to the left or right. It drove me crazy! My eye dr said they were positioned well and he was amazed I could feel them. Anyone else have any such trouble? Perhaps I will have to consider cautery occlusion one day...